Dundee Cancer Centre, University of Dundee, Ninewells Hospital and Medical School, Mailbox 4, Level 6, Dundee, DD1 9SY, Scotland.
Radiology. 2012 Jun;263(3):673-7. doi: 10.1148/radiol.12111317. Epub 2012 Apr 20.
To compare the histologic prognostic feature of invasive breast cancer with mean stiffness as measured with shear-wave elastography.
This retrospective study was exempted from ethical committee review. Patient consent for use of images for research was obtained. The study group comprised 101 consecutive women (age range, 38-91 years) with solid lesions identified during routine breast ultrasonography (US) performed between April 2010 and March 2011 and subsequently confirmed at histologic examination to be invasive cancers. Four elastographic images in two orthogonal planes were obtained of each lesion, and mean stiffness values were obtained from each image. Histologic findings following surgery were used for comparison, namely histologic grade, tumor type, invasive size, vascular invasion status, and lymph node status. Relationship between mean stiffness and histologic parameters was investigated by using a general linear model and multiple regression analysis.
High histologic grade (P < .0001), large invasive size (P < .0001), lymph node involvement (P < .0001), tumor type (P < .0001), and vascular invasion (P = .0077) all showed statistically significant positive association with high mean stiffness values. Multiple linear regression indicated that invasive size is the strongest pathologic determinant of mean stiffness (P < .0001), with histologic grade also having significant influence (P = .022).
In this study, breast cancers with higher mean stiffness values at shear-wave elastography had poorer prognostic features.
比较浸润性乳腺癌的组织学预后特征与剪切波弹性成像测量的平均硬度。
本回顾性研究获得伦理委员会豁免，并获得了患者同意使用图像进行研究。研究组包括 101 名连续女性患者（年龄 38-91 岁），她们在 2010 年 4 月至 2011 年 3 月期间常规进行乳腺超声（US）检查时发现有实体性病变，随后在组织学检查中证实为浸润性癌。对每个病变进行了 4 个弹性成像图像的两个正交平面获取，并从每个图像中获得平均硬度值。使用手术后的组织学发现进行比较，即组织学分级、肿瘤类型、浸润大小、血管浸润状态和淋巴结状态。使用一般线性模型和多元回归分析研究平均硬度与组织学参数之间的关系。
高组织学分级（P<0.0001）、大浸润大小（P<0.0001）、淋巴结受累（P<0.0001）、肿瘤类型（P<0.0001）和血管浸润（P=0.0077）均与高平均硬度值呈统计学显著正相关。多元线性回归表明，浸润大小是平均硬度的最强病理决定因素（P<0.0001），组织学分级也有显著影响（P=0.022）。
在本研究中，剪切波弹性成像上平均硬度值较高的乳腺癌具有较差的预后特征。
